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Role of Histopathology in Autoimmune Hepatitis

Lookup NU author(s): Dr Dina Tiniakos, Dr John Brain, Dr Yvonne BuryORCiD


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The diagnosis of autoimmune hepatitis (AIH) is based on a combination of biochemical, immunological and histological features and exclusion of other causes of liver disease. Typical histological features include a chronic hepatitis pattern of injury with portal inflammation and interface activity, predominance of plasma cells in the portal infiltrate, emperipolesis, and hepatocellular rosette formation. Centrilobular injury with prominent hepatocellular necrosis and mononuclear inflammation is now recognised in the histological spectrum of AIH and may represent an early stage of the disease. Liver histology plays a major role in clinical diagnostic scoring systems and is important to confirm or support the clinical diagnosis of AIH. This review will focus on the role of histopathology in AIH and will highlight the contribution of histological interpretation to the diagnosis of AIH, differential diagnosis from other entities, recognition of concurrent liver disease, and identification of so called ‘overlap” or variant syndromes, and will address the importance of liver biopsy in the management and prognosis of patients with AIH.

Publication metadata

Author(s): Tiniakos DG, Brain JG, Bury YA

Publication type: Review

Publication status: Published

Journal: Digestive Diseases

Year: 2015

Volume: 33

Issue: Suppl. 2

Pages: 53-64

Online publication date: 07/12/2015

Acceptance date: 01/09/2015

ISSN (print): 0257-2753

ISSN (electronic): 1421-9875


DOI: 10.1159/000440747